COMMON BENIGN MUCOSAL SWELLINGS

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COMMON BENIGN MUCOSAL SWELLINGS:

COMMON BENIGN MUCOSAL SWELLINGS DR. SHAFAQ SALIM Prepared by: Dr. Batool Mohsin Khan

ACKNOWLEDGEMENT:

ACKNOWLEDGEMENT Dr. Batool Mohsin Khan

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FIBROUS POLYP FIBROUS EPULIS DENTURE INDUCED GRANULOMA PAPILLARY HYPERPLASIA PYOGENIC GRANULOMA & PREGNANCY EPULIS GIANT CELL EPULIS & PAPILLOMA Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

FIBROUS POLYP::

FIBROUS POLYP: Also known as: Fibro-epithelial polyp & fibroma . Benign soft tissue swelling protruding from mucous membrane. Non neoplasm, hyperplastic swelling. CLINICAL FEATURES: AGE : Can occur at any age but most common in 3 rd and 5 th decade of life. SITE : Gingiva , tongue, buccal mucosa, palate. It develops in site subject to chronic minor injury/ low grade infection. Prepared by: Dr. Batool Mohsin Khan

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SYMPTOMS : Painless swelling. SIGNS: Inflammed , superficial ulceration, irritable. APPEARANCE : Sessile, dome shape or slightly pedunculated with smooth contour. COLOUR : Normal, reddish if inflammed . CONSISTANCY : Firm & elastic. MANAGEMANT: Should be excised along with the small base of normal tissue. DIFFERENTIAL DIAGNOSIS: Lipofibroma Myofibroma Prepared by: Dr. Batool Mohsin Khan

FIBROUS EPULIS::

FIBROUS EPULIS: EPILUS (literally ‘on gingiva ’) is any benign lesion situated on gingiva . Reactive hyperplastic . Caused by irritation of the gingival margin by any sharp edge of carious cavity or by calculus. CLINICAL FEATURES: AGE: Can occur at any age. SITE: Most commonly near the front of the mouth on the gingiva between two teeth. APPEARANCE: Dark red granulation tissue. Prepared by: Dr. Batool Mohsin Khan

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SYMPTOM: Painless. SIGNS: Firm, haemorrhagic , inflammed swelling which may upgrade ulceration. MANAGEMENT: Bone curretage . Source of irritation should be removed ( caries/calculus) Excisional biopsy should be performed. Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

DENTURE INDUCED GRANULOMA::

DENTURE INDUCED GRANULOMA: Also known as: Denture induced hyperplasia, epulis fissuratum . Chronic irritation and hyperplastic response of alveolar or palatal mucosa caused by pressure/ irritation from denture flanges. CLINICAL FEATURES: AGE: At any age, usually middle aged or elderly patients who wear denture. SITE: Palate, alveolar mucosa. APPEARANCE: Pale, firm swelling. Prepared by: Dr. Batool Mohsin Khan

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SYMPTOM: Painless growth. APPEARANCE: Firm swelling with smooth pink surface. MANAGEMENT: Removal of the cause (denture flanges should be relieved to prevent recurrence). Excision of fibroma . LEAF FIBROMA: Fibrous outgrowth which forms under the denture but has become flattened again the palate. Difficult to see until lifted away from its bed. Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

PAPILLARY HYPERPLASIA OF PALATE::

PAPILLARY HYPERPLASIA OF PALATE: Nodular overgrowth of palatal mucosa seen particularly under denture in older person with low grade trauma or infection. Mild papillary hyperplasia is also seen in non denture wearers. Candidosis is sometimes superimposed CLINICAL FEATURES: AGE : Any age. Denture wearers. Patients with poor oral hygiene. SITE: On palate beneath the partial or complete denture, predominantly in edentulous patients. Site corresponds to denture base. Prepared by: Dr. Batool Mohsin Khan

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APPEARANCE: Numerous closely arranged red erythematous papillary projections involving nearly all of the hard palate. When complicated with candida , it may appear as red to scarlet soft lesion and bleeds easily in inflammation state. SIGN: Irritable lesion, bleeds with minute trauma, covered with thin whitish exudate . Signs of inflammation may be seen. Prepared by: Dr. Batool Mohsin Khan

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MANAGEMENT: Denture should be kept clean and not worn at night. If superimposed with candidal infection , antifungal drugs should be given. Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

PYOGENIC GRANULOMA & PREGNANCY EPULIS::

PYOGENIC GRANULOMA & PREGNANCY EPULIS: PREGNANCY EPULIS: Also known as ‘pregnancy tumor’. Well defined lesion gradually increases in size and may or may not regress after delivery. Due to improper oral hygiene, hormonal factors, local irritants. Usually associated with pregnancy gingivitis. CLINICAL FEATURES: SITE: Gingiva , lip, tongue, buccal mucosa, palate, vestibule, alveolar mucosa. Generally occurs in 2 nd or 3 rd trimester. SYMPTOMS: Asymptomatic nodular mass. SIGN: Some times purulent discharge. Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

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PYOGENIC GRANULOMA: Soft tissue lesion of skin and mucous membrane. Reactive inflammatory process in which there is fibrous proliferation of connective tissue secondary to chronic inflammation. CLINICAL FEATURES: AGE: More common in females between age of 11-14 years. SITE: Gingiva is common site. APPEARANCE: Elevate, pedunculated or sessile with smooth lobulated warty surface. Bleeds with slight pressure or trauma. Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

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MANAGEMENT: PYOGENIC GRANULOMA: Surgical excision of the lesion. Removal of calculus which may act as local irritant and causes recurrence. PREGNANCY EPULIS: Maintain oral hygiene. The lesion usually resolves after delivery. DIFFERENTIAL DIAGNOSIS: Exophytic capillary haemengioma Small benign & malignant mesenchymal tissues Peripheral giant cell granuloma Prepared by: Dr. Batool Mohsin Khan

PAPILLOMA:

PAPILLOMA Common benign growth on the skin or mucous membrane, arising from the surface of epithelium. May be caused by ‘Human papilloma viruses’ (HPVs). CLINICAL FEATURES: SITE: Tongue, palate, buccal mucosa, gingiva , lip, floor of the mouth. APPEARANCE : exophytic , pedunculated , cauliflower-like benign neoplasm of epithelium, often having a “warty appearance.” CONSISTENCY : Firm if keratinized, soft if non-keratinized. Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

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MANAGEMENT : Excision of the lesion with its base to prevent recurrence. DIFFERENTIAL DIAGNOSIS : Verruca vulgaris Papillary squamous cell carcinoma Verrucas carcinoma Prepared by: Dr. Batool Mohsin Khan

GAINT CELL EPULIS:

GAINT CELL EPULIS GIANT CELL: Mass formed by the union of several distinct cells (usually macrophages). It can arise in response to an infection, such as from tuberculosis, herpes, or HIV, or foreign Body. Prepared by: Dr. Batool Mohsin Khan

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PERIPHERAL: It is like fibrous epulis , hyperplastic but less common. CLINICAL FEATURES : SITE: On gingival margin between teeth anterior to permanent molars. Its development is related to resorption of deciduous teeth. APPEARANCE : Swelling is round ,soft and typically maroon or purplish. Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

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MANAGEMENT: Excision along with the gingival base. Curretage of underlying bone. Adjacent teeth not to be extracted if they are healthy. CENTRAL: Central giant is a benign lesion of jaws of unknown etiology. It as an intraosseous lesion consisting of cellular fibrous tissue that contains multiple foci of hemorrhage, aggregations of multinucleated giant cells and occasionally trabeculae of woven bone. Prepared by: Dr. Batool Mohsin Khan

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CLINICAL FEATURES: They are characterized by large lesions that expand the cortical plate and can resorb roots and move teeth. AGE: 20-40 years of age, common in females. SITE: Common in the mandible and often cross the midline. SYMPTOMS: Painless swelling. Can cause paresthesia . SIGN: Tender on palpation. MANAGEMENT: Curettage Surgical excision DIFFERENTIAL DIAGNOSIS: Amelobalstoma Odontogenic myxoma Hemangioma Prepared by: Dr. Batool Mohsin Khan

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Prepared by: Dr. Batool Mohsin Khan

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